中耳貯留液からコレステリン結晶が検出された滲出性中耳炎の臨床的検討

抄録

Persistent secretory otitis media in 20 children at Chiba Children's Hospital was investigated, andcholesterol crystal was found in middle ear fluid.
1. Among total of 20 children, the disease was bilateral in5children and unilateral in 15.
2. Persistent secretory otitis media were mostly diagnosed in children younger than 10 years of age.The period of suffering in the bilateral cases was 18 months on average and the unilateral cases was 31 months.
Their tympanic membranes showed dark red, blue, or amber color.
Their hearing was worse than that of children with common types of secretory otitis media.
Mastoid cells showed poor development on radiographs.
3. Of 25 ears, 23 were treated only with insertion of ventilating tube. Through the tube18ears hadred brown discharge, which continued for about a month and they showed frequent bacterial infection.
4. The prognosis of secretory otitis media with cholesterol crystal was worse than that withoutcholesterol crystal. In addition, it was suggested that some patients with secretory otitis media withcholesterol crystal had cholesterol granuloma. It was also considered that the presence of cholesterolgranuloma is related to the clinical course of secretory otitis media.
5. We conclude that the presence of cholesterol crystal in middle ear fluid indicates prolonged clinicalcourse in secretory otitis media.